下呼吸道葡萄球菌感染的耐药性分析和治疗对策

目的通过对2002年1月至2005年12月期间，临床下呼吸道标本分离到的423株葡萄球菌进行耐药性分析，以了解葡萄球菌的耐药情况，指导临床合理使用抗生素。方法用VITEK系统对所分离的葡萄球菌进行鉴定，按美国临床实验室标准委员会推荐的标准方法（K—B法）进行药敏试验。结果423株葡萄球菌中凝固酶阴性葡萄球菌（CNS）325株。占76．8％．其中耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）311株．检出率为95．7％，耐甲氧西林的金黄色葡萄球菌（MRSA）的检出率为76．5％。MRS对万古霉素100％敏感，对利福平和呋喃妥因敏感性高。结论我院MRS检出率高，应重视对MRS耐药性监测。治疗MRS引起的严重呼吸道感染应首选万古霉索。合理应用抗生素是延缓细菌耐药性的关键。

Study on antimicrobial resistance and therapeutic strategy on staphylococcus infections in lungs

Objective To survey the resistance of Staphylococcus, and to provide the reference for the clinical antimicrobial agents usage. Methods The identification and drug susceptibility tests were carried out with Vitek for Staphylococcus. Results Among 423 strains of staphylococcus, 325 strains were resistant coagulase negative staphylococcus(CNS), of which 311 strains were methicillin resistant coagulase negative staphylococcus(MRCNS) with the detectiong rate of 95.7%. MRS was susceptible to vancomycin, nitrofurantoin and rifampin. Conclusions Much attention should been paid to detecting MRS, the resistance of MRS to antibiotics should be further monitored. Vancomycin may be used for the treatment of MRS infection first.